Provider Demographics
NPI:1982882833
Name:TELLO, JOCELYN AMANDA (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:AMANDA
Last Name:TELLO
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Gender:F
Credentials:PSYCHOLOGIST
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Mailing Address - Street 1:400 E EVERGREEN BLVD
Mailing Address - Street 2:SUITE 313
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3331
Mailing Address - Country:US
Mailing Address - Phone:360-931-0605
Mailing Address - Fax:360-859-4533
Practice Address - Street 1:400 E EVERGREEN BLVD
Practice Address - Street 2:SUITE 313
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3331
Practice Address - Country:US
Practice Address - Phone:360-931-0605
Practice Address - Fax:360-859-4533
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-03
Last Update Date:2012-07-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPY3900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical